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I read with interest James Caves response to Easterbrookes 'personal
view' and would agree with the points he makes. It is important however to
recognise that most new principals get a very unstructured and often
traumatic entry into their first principals post. I recently asked a group
of young principals, all within their early years in practice, to identify
factors which would have made their entry into practice better. The
following were the outcomes:
Induction:
All agreed that every new partner should have a period of induction
similar to that provided for new GP Registrars.
A nominated doctor
All wished that they had a clearly identified partner in the practice to
whom they could relate in their early years in practice. This was not a
true mentor role but someone who would clarify organisational matters and
give feedback on performance as they settled into practice.
Protected Time
In the early months in practice new partners should have time protected
from clinical work in which to develop understanding about the systems and
organisation of the practice, and also time just to think and reflect on
their work.
Appraisal
Whilst many partnerships have a six months mutual Assessment, there was a
common feeling that no true feedback was given at the end of this period.
New principals would appreciate a discussion about their strengths and
weaknesses at this stage. It was recognized that the skills to give this
feedback may not be developed in all partnerships and they wondered if an
independent person would be needed to facilitate this discussion.
Equality?
All felt that they were treated as an equal in terms of work and
involvement once they began in practice, but recognized that they still
had much to learn. They were unclear about how this was to be achieved but
all felt that there should be recognition that they were not an equal to
an established, experienced principal.
Practice Style
Information about workload, consulting speeds, style of working of
partners was felt to be a need.
Can I leave?
There was a clear anxiety about leaving a practice after the six months
assessment period and how this was to be handled.
All of these areas seem reasonable, and easily achievable. Why don't
most practices do it?
George Taylor
Deputy Director
General Practice
Newcastle University
1 Cave. J. All new GPs have problems when they first start in
practice. BMJ 1999,318:1569 (letter)
2 Easterbrooke.J.The emperor has no clothes on. BMJ.1999,318:173
Factors which would have made entry into practice better
Dear Sir
I read with interest James Caves response to Easterbrookes 'personal
view' and would agree with the points he makes. It is important however to
recognise that most new principals get a very unstructured and often
traumatic entry into their first principals post. I recently asked a group
of young principals, all within their early years in practice, to identify
factors which would have made their entry into practice better. The
following were the outcomes:
Induction:
All agreed that every new partner should have a period of induction
similar to that provided for new GP Registrars.
A nominated doctor
All wished that they had a clearly identified partner in the practice to
whom they could relate in their early years in practice. This was not a
true mentor role but someone who would clarify organisational matters and
give feedback on performance as they settled into practice.
Protected Time
In the early months in practice new partners should have time protected
from clinical work in which to develop understanding about the systems and
organisation of the practice, and also time just to think and reflect on
their work.
Appraisal
Whilst many partnerships have a six months mutual Assessment, there was a
common feeling that no true feedback was given at the end of this period.
New principals would appreciate a discussion about their strengths and
weaknesses at this stage. It was recognized that the skills to give this
feedback may not be developed in all partnerships and they wondered if an
independent person would be needed to facilitate this discussion.
Equality?
All felt that they were treated as an equal in terms of work and
involvement once they began in practice, but recognized that they still
had much to learn. They were unclear about how this was to be achieved but
all felt that there should be recognition that they were not an equal to
an established, experienced principal.
Practice Style
Information about workload, consulting speeds, style of working of
partners was felt to be a need.
Can I leave?
There was a clear anxiety about leaving a practice after the six months
assessment period and how this was to be handled.
All of these areas seem reasonable, and easily achievable. Why don't
most practices do it?
George Taylor
Deputy Director
General Practice
Newcastle University
1 Cave. J. All new GPs have problems when they first start in
practice. BMJ 1999,318:1569 (letter)
2 Easterbrooke.J.The emperor has no clothes on. BMJ.1999,318:173
Competing interests: No competing interests